Report 2023-103 Recommendation 6 Responses

Report 2023-103: The Comprehensive Perinatal Services Program: The Lack of Usage Data Prevents the State From Knowing How Often Medi‑Cal Members Receive Perinatal Care (Release Date: February 2024)

Recommendation #6 To: Health Care Services, Department of

To ensure that providers are adequately trained on the requirements of the perinatal program, beginning in January 2025 Health Care Services should require that managed care plans ensure and document that providers have received training as appropriate. At a minimum, this training should include what services are available and how to document that providers offered those services.

6-Month Agency Response

DHCS continues the plan to align any policy work in this space with existing Birthing Care Pathways work. However, as noted in Recommendation 3, the timeline for the release of DHCS' public report has shifted. It is now scheduled to be released in Quarter 3 of 2024. The report will still outline various policy recommendations, including those related to CPSP modernization, and therefore will help inform additional next steps.

In the interim, DHCS, in partnership with CDPH, conducted a comprehensive, internal assessment of all existing Medi-Cal provider-facing materials. This includes policy guidance and training to identify opportunities for making refinements to increase awareness to the comprehensive suite of pregnancy and pregnancy-related services and supports available to Medi-Cal members, including CPSP services to ensure Medi-Cal providers are aware of all policy requirements.

DHCS is in the process of creating a brand-new maternal health care webpage with a dedicated CPSP subpage with resources for both Medi-Cal members and providers. Additionally, DHCS is currently working on updating the CPSP California Medicaid Management Information System provider training relative to all CPSP-related information to ensure it is clear and comprehensive. Additionally, DHCS is continuing to work with CPDH to coordinate CPSP-specific training which compliments DHCS' CPSP billing training, which is estimated to be finalized in Fall 2024.

Lastly, DHCS is still planning to require Medi-Cal MCPs to independently ensure providers have training on the comprehensive suite of pregnancy and pregnancy-related benefits and services covered under Medi-Cal, and training is documented.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

DHCS continues the plan to align any policy work in this space with existing Birthing Care Pathways work. DHCS' public report is scheduled to be released in Summer 2024 and will outline various policy recommendations, including those related to CPSP, and therefore help inform the next steps on this front. DHCS will report recommendations and in partnership with CDPH, will conduct an internal assessment of all existing Medi-Cal provider-facing materials, including policy guidance and training, to identify opportunities for making refinements to increase awareness as to the comprehensive suite of pregnancy and pregnancy-related services and supports available to Medi-Cal members, including CPSP services, and ensure Medi-Cal providers are aware of all policy requirements. In addition to DHCS/CDPH's work in this space, DHCS will also require MCPs to independently ensure that providers have training on the comprehensive suite of pregnancy and pregnancy-related benefits and services covered under Medi-Cal, and that training is documented. Additionally, by January 2025, DHCS plans to incorporate a contractual requirement for MCPs to document providers of perinatal services have been trained. DHCS can require the documentation of training by each MCP is submitted to DHCS by June 2025.

California State Auditor's Assessment of 60-Day Status: Pending

All Recommendations in 2023-103

Agency responses received are posted verbatim.